Articles: postoperative-pain.
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Ann. Otol. Rhinol. Laryngol. · Nov 2020
Factors Affecting Post-Anesthesia Care Unit Length of Stay in Pediatric Patients after an Adenotonsillectomy.
(1) To identify clinical factors and perioperative practices that correlate with longer length of stay (LOS) in the post-anesthesia care unit (PACU) after adenotonsillectomy (T&A) in pediatric populations.(2) To understand the relationship between family presence and PACU LOS for pediatric patients after T&A. ⋯ Our results suggest that postoperative medication administration and time until family arrival in the PACU are associated with significant differences in LOS. We also find that intraoperative administration of acetaminophen is correlated with reduced need for postoperative medication administration. Standardizing postoperative practices to minimize PACU LOS could result in a more efficient recovery for pediatric patients undergoing T&A.
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Multicenter Study Clinical Trial
10 kHz SCS for chronic postsurgical pain: Results from a 12-month prospective, multicenter study.
Chronic postsurgical pain (CPSP) can be caused by peripheral nerve injury (PNI) resulting from surgical procedures and has a significant neuropathic component. This prospective, single-arm study was conducted to document the effectiveness of 10-kHz spinal cord stimulation (10-kHz SCS) as a treatment for patients with CPSP. ⋯ 10-kHz SCS is effective and tolerated in patients with CPSP, and further study of its clinical application in this population is warranted.
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Minerva anestesiologica · Nov 2020
Pediatric pain review: what has happened since the First World Congress on Pediatric Pain in 1988? The past, the present and the future.
The present article summarizes the development within the field of pediatric pain during the last 30 years, with a special focus on pediatric postoperative pain. Insights concerning pain ontogeny, how pain influences the neuro-endocrine stress response and the induction of a "pain memory" is discussed as well as established and new options with regards to treatment of postoperative pain. Lastly, some aspects concerning future development within this field is discussed. ⋯ The use of regional anesthetic techniques should be used whenever possible and combined with appropriate systemic options, thereby producing multi-modal analgesia. However, new concepts and drugs are unfortunately few and, thus, progress often lies in using established drugs in more efficient ways. The concept of Enhanced Recovery After Surgery (ERAS) also provides a framework where high-quality postoperative pain relief is of essence for the best possible outcome after both minor and major surgery.
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Chronic pain after groin hernia repair is a significant problem, and it is unclear whether or not lightweight meshes help. This national register-based study investigated whether patients who underwent open anterior mesh inguinal hernia repair with lightweight mesh had less chronic pain than those who had hernia repair with heavyweight mesh. ⋯ Patient-reported chronic pain 1 year after open mesh repair of inguinal hernia was common, particularly in young men. The risk of developing chronic pain was not influenced by the type of mesh.
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Within the context of the United States opioid epidemic, some parents often fear the use of opioids to help manage their children's postoperative pain. As a possible consequence, parents often do not dispense optimal analgesic medications to their children after surgery, putting their children at risk of suffering from postsurgical pain. The objective of this research was to assess ethnicity as a predictor of both pain and opioid consumption, and to examine how Hispanic/Latinx and Non-Hispanic White parents alter their child's opioid consumption in response to significant postsurgical pain. ⋯ Hispanic/Latinx children might be at risk for undertreatment of surgical pain. Findings highlight the importance of assessing parent background and cultural beliefs as predictors of at home pain management and the potential effectiveness of tailored interventions that educate parents about monitoring and treating child postoperative pain.